NPIMap

Organization Active NPI

John Walsh DDS PA

  • General Practice Dentistry
  • Spring Lake, NC
National Provider Identifier
1366717530
Registry record updated Sep 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4305 Issued in NC
Legal business name
JOHN WALSH DDS PA
Practice address
101 Sleepy Dr
Suite 102
Spring Lake, NC 28390-3317
Phone
(910) 497-2969
Fax
(910) 497-6505
NPI assigned
Mar 20, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Jessica Johnston
Title
Operations Manager
Phone
(704) 522-1550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 4305 NC Primary

Addresses

Primary practice location

101 Sleepy Dr
Suite 102
Spring Lake, NC 28390-3317

Mailing address

5821 Fairview Rd
Suite 220
Charlotte, NC 28209-5601
Phone (704) 522-1550

Other names 1

  • Dentistry of the Carolinas Doing business as

National Provider Directory

National Provider Directory
Tax ID family
John Walsh DDS PA11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5821 Fairview Rd
Ste 220
Charlotte, NC 28209

101 Sleepy Dr
#102
Spring Lake, NC 28390
Phone (910) 497-2969

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1332201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378771200000",
    "number": "1366717530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5821 FAIRVIEW RD",
            "address_2": "SUITE 220",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282095601",
            "telephone_number": "704-522-1550",
            "fax_number": "704-522-1558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SLEEPY DR",
            "address_2": "SUITE 102",
            "city": "SPRING LAKE",
            "state": "NC",
            "postal_code": "283903317",
            "telephone_number": "910-497-2969",
            "fax_number": "910-497-6505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN WALSH DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-20",
        "last_updated": "2013-09-10",
        "status": "A",
        "authorized_official_last_name": "JOHNSTON",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "704-522-1550",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "4305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dentistry of the Carolinas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spring Lake, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.